OC15.03: Pregnancy complications related to velamentous umbilical cord insertion

To assess VUCI incidence in pregnancy, its complications, and 2D/PD ultrasound diagnostic accuracy. A retrospective study from January 2014 to December 2023 analysed morphology ultrasounds (20-24 weeks) assessing umbilical cord using 2D/PD ultrasound and placenta macroscopic evaluation at birth by obstetricians. Stored in SIM database, data underwent Z-test for accuracy analysis of both modalities. A total of 8,165 patients had a successful evaluation of the umbilical cord insertion at the placental insertion and 138 (1.7%) had the ultrasound diagnosis of VUCI confirmed by macroscopic evaluation at birth, PD ultrasound studies successfully identified 127 cases of VUCI, which were confirmed at birth, yielding a sensitivity of 92% and a specificity of 100%. Within the VUCI cohort, perinatal mortality was 3.6%, attributable to complications such as intra-amniotic hemorrhage and labour issues, compared to a 0.04% mortality rate in the control group, which was associated with thrombophilias and fetal infections. Preterm labour occurred in 17.4% of patients in the VUCI group, as opposed to 3% in the control group. Moreover, vasa previa was present in 8.7% of the VUCI cases, in contrast to only 0.02% in the control group, resulting in a significant Z-score for these complications (Z < 0.02). There were no significant differences in birthweight between both groups. While VUCI is rare, its significant association with prenatal risk, as shown in this study, warrants screening. A PD ultrasound between 20 to 24 weeks should be considered to examine umbilical cord insertion. Early detection allows for optimal prenatal monitoring and management. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.